Heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients.

BACKGROUND: Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are used for diagnosis and follow-up of patients with intact immunoglobulin multiple myeloma. However, the numerous limitations of these methods led to the development of a nephelometric immunoassay (Hevylite™) for the specific measurement of serum IgGκ, IgGλ, IgAκ and IgAλ concentrations. METHODS: In this study, we evaluated the correlation between this assay and SPE and IFE in 114 sera of 15 patients (12 IgG and 3 IgA patients) and its impact on the clinical care of patients, especially for diagnosis, for the evaluation of residual disease and for early detection of relapse. RESULTS: At inclusion and during follow-up, we found a good correlation between monoclonal immunoglobulin concentrations and SPE (R(2)=0.902 for IgA and R(2)=0.915 for IgG) and nephelometric quantification (R(2)=0.948 for IgA and R(2)=0.920 for IgG) for the evaluation of monoclonal and polyclonal immunoglobulins. Our results illustrate that the Hevylite™ test is less sensitive than the IFE for detection of residual disease: 5 patients who obtained very good partial response or complete response had normalization of the Hevylite™ ratio while IFE was still positive. A relapse had been detectable with the Hevylite™ ratio 1 to 2 months earlier than with SPE and IFE in 3 patients out of 15, but no recommendations for treating patients with only slight biological relapse are available. CONCLUSION: Our results demonstrate that heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients. We also studied the correlation between the concentration of total immunoglobulin measured by Hevylite™ (sum of Ig'κ + Ig'λ) and nephelometric measurement of total IgG or IgA. For this correlation analysis, all 114 sera were analyzed. The correlation coefficient was R(2) = 0.948 for IgA and R(2) = 0.920 for IgG.

[Usefulness of a free light chain immunoassay in serum for the diagnosis and the follow-up of monoclonal gammopathy]. / Intérêt du dosage des chaînes légères libres d'immunoglobulines sériques pour le diagnostic et le suivi des gammapathies monoclonales.

PURPOSE: Monoclonal immunoglobulin free light chains (FLC) are present in the serum and urine of many patients with monoclonal gammopathies. In this review, we discuss the usefulness of serum FLC determination for diagnostic, prognostic and monitoring of multiple myeloma (MM), AL amyloidosis and monoclonal gammopathies of undetermined significance (MGUS). CURRENT KNOWLEDGE AND KEY POINTS: Serum FLC assay is a useful laboratory test for management of light chain MM, non-secretory MM and AL amyloidosis. Currently, serum FLC testing cannot be recommended for monitoring intact immunoglobulin multiple myeloma. Even though serum FLC determination give a better risk stratification for MGUS, systematic serum FLC assay should not be used in routine because of high MGUS occurrence in the general population. FUTURE PROSPECTS AND PROJECTS: Further prospective studies with large cohorts of patients should provide additional evidence for the role of serum FLC measurement in patients with intact immunoglobulin multiple myeloma.

Eukaryotic translation termination factor gene (ETF1/eRF1) maps at D5S500 in a commonly deleted region of chromosome 5q31 in malignant myeloid diseases.

The human genome contains four ETF1 (eukaryotic translation termination factor 1) homologous sequences, localized on chromosomes 5, 6, 7 and X, and corresponding to a functional gene on chromosome 5 and three processed pseudogenes on the other chromosomes. ETF1 genomic or cDNA probes were mapped by fluorescence in situ hybridization to 5q31, 6p21, 7q11 and Xp11.4-->p11.1. A microsatellite marker (D5S500) was identified in intron 7 of the functional ETF1 gene providing its exact position in the 5q31 band. Thus, the ETF1 gene is located in a 5q region which contains unidentified genes responsible for genetic or malignant disorders, and it might be considered as a candidate gene involved in the pathogenesis of these diseases.

Human release factor eRF1: structural organisation of the unique functional gene on chromosome 5 and of the three processed pseudogenes.

In lower and higher eukaryotes, a family of tightly related proteins designated eRF1 (for eukaryotic release factor 1) catalyses termination of protein synthesis at all three stop codons. The human genome contains four eRF1 homologous sequences localised on chromosomes 5, 6, 7 and X. We report here the cloning and the structural analysis of the human eRF1 gene family. It appears that the gene located on chromosome 5 alone is potentially functional, whereas the other three sequences resemble processed pseudogenes. This is the first description of the structural organisation of the human eRF1 gene, which has been remarkably conserved during evolution and which is essential in the translation termination process.

Proteases.

Proteases are enzymes which are widely distributed in cells and play a key role in protein metabolism. The aim of this paper is to review the classification and nomenclature of proteases, their catalytic mechanisms, the regulation of proteolytic activity and finally the major biological functions of proteases.

Effects of perhexiline maleate on asialo-orosomucoid receptor endocytosis and recycling in HTC cells.

Perhexiline is a lysosomotropic agent which has proved to be very valuable to certain patients suffering from angina pectoris. However long-term administration of the drug may induce hepato- and neuro-toxicity. Using HTC cells (a rat hepatoma-derived cell line) whose plasma membranes were labeled with NaB[3H]4 after oxidation by NaIO4, endocytosis and recycling of labeled asialo-orosomucoid (ASOR) receptors were investigated in the presence of 50 mumols/l perhexiline maleate. The results demonstrate that the drug induces a significant decrease of the rate of both the internalization and the recycling of ASOR receptors. The mechanisms responsible for these effects have not yet been elucidated. However, the current findings may be related to the previously observed inhibitory effect of perhexiline on cellular (Na+, K+)-ATPase and Mg++-ATPase activities. Our findings would then reflect insufficient cellular energy production, resulting from depressed ATP hydrolysis in the presence of perhexiline.

Pathophysiological variations in the rat liver plasma membrane serine proteinase activity.

The effects of fasting, diabetes, cholestasis, two-third hepatectomy and adrenalectomy on the rat liver plasma membrane serine proteinase activity were studied. Our results show a significant decrease of the enzyme activity during fasting (-50%), during experimental diabetes (-50%), in regenerating liver after partial hepatectomy (-70%) and after extrahepatic cholestasis (-70%). No modifications are noted when the rats are bilaterally adrenalectomized. These findings suggest that the enzyme activity may be linked to the level of circulating insulin, and may be regulated in physiological cellular proliferation so as to prevent undesirable protein degradation.

Inhibition of (Na+,K+)-ATPase and Mg++-ATPase by a lysosomotropic drug: perhexiline maleate.

Human clinical observations and in vivo studies have shown that the amphiphilic drug perhexiline maleate is responsible for lipidosis storage disorders. When the drug was incubated in vivo with rat brain homogenates, the ouabain-sensitive (Na+,K+)-ATPase and the Mg++-ATPase activities were inhibited. 50% inhibition occurred at the drug concentrations 5.10(-5) M for (Na+,K+)-ATPase and at 10(-4) M for Mg++-ATPase, respectively. Kinetic studies performed on rat brain homogenates showed a mixed type inhibition of these enzymes by perhexiline maleate. The effect of other lysosomotropic drugs (imipramine, chlorpromazine, thioridazine and tamoxifen) on (Na+,K+)-ATPase and on Mg++-ATPase activities was found to be similar to that induced by perhexiline maleate. These results indicate that the inhibitory effect of perhexiline maleate on (Na+,K+)-ATPase and Mg++-ATPase may be a common feature shared by the lysosomotropic drugs.

Partial purification and characterization of a serine endopeptidase from rat liver plasma membranes.

A serine endopeptidase was partially purified from rat liver plasma membranes by using a four-step procedure: solubilization with N-lauroylsarcosine; Ultrogel AcA-34 chromatography; CM Affi-Gel blue chromatography; agarose-soybean trypsin inhibitor chromatography. This enzyme was found to hydrolyze casein and various chromogenic peptide substrates; highest activity occurred with H-D-Val-Leu-Arg-p-nitroanilide, reported to be a specific substrate for human glandular kallikreins. The enzyme was heat-sensitive, showed a pH optimum between 8.0 and 9.0 and was inhibited by D-Phe-L-Phe-L-Arg-CH2Cl, aprotinin, diisopropyl fluorophosphate (DFP), soybean trypsin inhibitor, phenylmethylsulphonyl fluoride, leupeptin, antipain and dithiothreitol. This liver plasma membrane proteinase has an apparent molecular weight of about 30 000 as determined by Ultrogel AcA-34 chromatography and by autoradiography of [3H]DFP-labelled protein electrophoresis.

Serum angiotensin-converting enzyme levels in patients with chronic renal failure.

Disagreement concerning serum angiotensin-converting enzyme (ACE) levels in patients with chronic renal failure has been observed in recent reports. Because ACE is considered as a useful tool for the diagnosis and management of sarcoidosis, and because chronic renal failure may be associated with sarcoidosis, the present work was designed to reinvestigate the possible changes of serum angiotensin-converting enzyme activity in a series of 36 non-hemodialysed consecutive patients with chronic non-sarcoid renal failure. Enzyme activity was significantly lower (p less than 0.004) in the patients (15.8 +/- 5.0 units/ml, mean value +/- 1 SD) than in 47 healthy controls (20.2 +/- 7.6 units/ml, mean value +/- 1 SD). Serum angiotensin-converting enzyme and creatinine clearance values were significantly correlated in these patients (p less than 0.0002). These results indicate that, in non-hemodialysed patients with chronic renal failure, serum angiotensin-converting enzyme levels may not be useful in establishing the diagnosis of sarcoidosis.

Properdin factor B (Bf) polymorphism: subtyping of SS phenotypes.

The authors have studied the genetic polymorphism of the properdin factor B (Bf) by the isoelectrofocusing technique. The SS phenotypes, all similar on agarose gel electrophoresis, were shown to be heterogeneous after isoelectrofocusing; this heterogeneity corresponds to the expression of two new suballeles SA and SB, inherited in a codominant manner. Gene frequencies for 121 individuals with SS phenotype are 0.57 for SA, and 0.43 for SB.

Forskolin requires more than the catalytic unit to activate adenylate cyclase.

Forskolin, a natural diterpene, is a novel, potent activator of a variety of adenylate cyclase systems; its mechanism and site of action are still disputed. We report here that, while forskolin activates liver adenylate cyclase up to 15-fold, it does not activate cyclase of ram sperm which comprises a pure catalytic subunit. However, forskolin activation of sperm adenylate cyclase activity could be observed after reconstitution with the regulatory component-enriched membrane from human erythrocytes. The diterpene weakly (3-5-fold) activated the cytosolic, soluble cyclase found in rat and ram tests, but this effect was lost when the cyclase was purified by gel chromatography. Our data are not compatible with the hypothesis that forskolin acts directly on the catalytic subunit, but rather suggest that it acts via another regulatory component, part of, or different from, the GTP-binding regulatory complex.